Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2011
Utility of bedside angiography in the evaluation of vascular obstruction in the pediatric intensive care patient.
To review our experience with bedside angiography in order to demonstrate the utility of this technique for evaluation of blood vessels in the critically ill patient. ⋯ Bedside angiography is a rapid, safe, and useful tool for the evaluation of complex vascular anatomy in critically ill patients. In cases where vascular ultrasound is unable to provide detailed anatomy or identify collateral flow, this technique may be useful in providing safe and accurate assessment of blood vessels associated with vascular access devices.
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Pediatr Crit Care Me · Jul 2011
Active surveillance culturing impacts methicillin-resistant Staphylococcus aureus acquisition in a pediatric intensive care unit.
To determine whether active surveillance culturing for methicillin-resistant Staphylococcus aureus (MRSA) decreases nosocomial MRSA acquisition in the pediatric intensive care unit. ⋯ Active surveillance culturing resulted in significantly decreased nosocomial acquisition of MRSA in a pediatric intensive care unit setting. Admission and weekly active surveillance culturing appears to be an effective tool to decrease the spread of MRSA in the pediatric intensive care unit, independent of improvement in hand hygiene compliance. The impact on hospital-acquired MRSA infections and the cost benefit of active surveillance culturing require further study.
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Pediatr Crit Care Me · Jul 2011
Development of a collaborative program to provide extracorporeal membrane oxygenation for adults with refractory hypoxemia within the framework of a pandemic.
We report the process used to rapidly develop a collaborative adult respiratory extracorporeal membrane oxygenation program as a response to caring for young adult patients with refractory hypoxemia in the setting of the pH1N1 pandemic. ⋯ In the setting of the pH1N1 influenza pandemic, an adult respiratory extracorporeal membrane oxygenation program was successfully developed to complement an established neonatal-pediatric program. This program expansion integrated all of the necessary components involved in the development process from start to finish and confirms that a healthcare system can respond very quickly and successfully to an urgent healthcare need.
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Pediatr Crit Care Me · Jul 2011
Monitoring in pediatric cardiac critical care: a worldwide perspective.
Our ability to directly monitor the mechanisms that govern cellular function, oxygen use, and survival is minimal. Therefore, in critically ill children, surrogate markers are used to try to detect evolving or established hypoxia. ⋯ These tools include standard invasive hemodynamic monitoring with electrocardiography, lactate measurement, central venous oxygen saturation, and echocardiography. Ultimately, monitoring is only useful when the clinician observes a specific value or trend and has the expertise to act appropriately.
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Pediatr Crit Care Me · Jul 2011
Flexible bronchoscopy for children on extracorporeal membrane oxygenation for cardiac failure.
To describe the safety and use of flexible bronchoscopy in the management of respiratory complications in patients on extracorporeal membrane oxygenation for cardiac failure. ⋯ In patients requiring extracorporeal membrane oxygenation for cardiac failure, flexible bronchoscopy can be performed safely, provide important diagnostic information to the bedside clinician, and, perhaps, therapeutic benefit to the patient.